title: Surgical strategy and management outcomes for adjacent multisegmental spinal tuberculosis: a retrospective study of forty-eight patients.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To evaluate the clinical outcomes of 4 different procedures for the treatment of adjacent multisegmental spinal tuberculosis (AMSST) and to investigate the selection strategy of the optimal procedure with respect to focal characteristics.
  
  
  BACKGROUND
  Because of the lack of support of the anterior columns of multiple segments, AMSST is thought to confer high risks for the development of kyphosis and paraplegia. However, there are few reports regarding the clinical outcomes of the surgical treatment for AMSST have been investigated.
  
  
  METHODS
  From August 1999 to June 2010, 48 patients with AMSST were enrolled in this study. Seven patients (A group) underwent a single-stage anterior operation. Eighteen patients (AP group) underwent a single-stage posterior and anterior combined operation. Eighteen patients (P group) underwent a single-stage posterior operation. Five patients (DP group) underwent computed tomography-guided drainage and local chemotherapy combined with a 2-stage posterior operation. The patients were followed up clinically and radiologically for an average of 29.6 months.
  
  
  RESULTS
  The cohort consisted of 29 males and 19 females, aged 4 to 54 years. The patients exhibited significant improvements in deformity and neurological deficits. Graft union was achieved in all patients 5 to 12 months postoperatively. Surgery-related complications were noted in 1 and 2 patients in the AP and P groups, respectively. Postoperative recurrence occurred in 1 and 2 patients in the AP and P groups, respectively. All 48 patients had been cured at the final follow-up.
  
  
  CONCLUSIONS
  This study demonstrated that the 4 procedures can safely and effectively achieve nerve decompression, graft fusion, and kyphosis correction. Individualized procedures should be chosen according to the patient's general condition, focal characteristic, type of complication, and surgeon's experience.
  
  
  METHODS
  3.
authors.affiliation: *Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, China †Department of Orthopaedics, The 309th Hospital of the PLA, Beijing, China; and ‡Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Litao
authors.initials: L
authors.lastname: Li
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Xu
authors.forename: Yuanzheng
authors.initials: Y
authors.lastname: Ma
authors.forename: Daidi
authors.initials: D
authors.lastname: Tang
authors.forename: Yonglin
authors.initials: Y
authors.lastname: Chen
authors.forename: Fei
authors.initials: F
authors.lastname: Luo
authors.forename: Dawei
authors.initials: D
authors.lastname: Li
authors.forename: Tianyong
authors.initials: T
authors.lastname: Hou
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhou
authors.forename: Fei
authors.initials: F
authors.lastname: Dai
authors.forename: Qingyi
authors.initials: Q
authors.lastname: He
authors.forename: Zehua
authors.initials: Z
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents